The overlapping relationship between emotion perception and theory of mind

Social neuropsychology of epilepsy in the digital age: A narrative review on challenges and opportunities

BACKGROUND AND OBJECTIVES

Social cognition (e.g., theory of mind and emotion recognition) is frequently impaired in people with epilepsy (PWE) and plays a critical role in social functioning. The impact of the digital revolution on the social neuropsychology of PWE remains underexplored, while clinical neuropsychology has been slow to incorporate technological advancements. This study aims to (a) evaluate the impact of digital communication on social cognition and functioning in PWE, and (b) explore the potential of digital tools to enhance their assessment.

METHODS

Given the limited and fragmented nature of the available research, a non-systematic, exploratory, narrative approach was adopted. Literature relevant to the interplay of digital communication, social cognition, and social functioning in PWE was synthesized to identify key areas for future research.

RESULTS

Digital communication differs from face-to-face interaction at phenomenological and neural levels; however, research on its effects in PWE remains scarce. Traditional social cognition assessments suffer from low ecological validity. Technological innovations, involving second-person paradigms and dynamic multimodal assessments, address these limitations. Digital biomarkers enable high-frequency, longitudinal data collection of intra-individual variability.

CONCLUSION

Digital tools offer the opportunity to improve the assessment of social cognition and functioning in PWE, especially regarding ecological validity, by enabling real-world, interactive, dynamic, and multimodal paradigms. Digital social cognitive proxies (e.g., markers of interactional synchrony) may help capture social cognition and functioning in highly dynamic disease trajectories in PWE more accurately. The interplay between social cognition, social functioning, and digital communication in PWE offers research opportunities into their complex and dynamic relationships.

Social cognition in autism and ADHD

Social cognition is a crucial capacity for social functioning. The last decades have seen a plethora of social cognition research in neurodevelopmental conditions, foremost autism and, to a lesser extent, ADHD, both characterized by social challenges. Social cognition is a multifaceted construct comprising various overlapping subdomains, such as Theory of Mind/mentalizing, emotion recognition, and social perception. Mechanisms underpinning social cognition are complex, including implicit and explicit, cognitive and affective, and hyper- and hypo-social information processing. This review explores the intricacies of social cognition in the context of autism and ADHD. Research indicates altered performance on social cognition tests in autism, compared to neurotypical groups, with social cognition alterations having a small but robust effect on the defining features of autism. The nature of such alterations in autism appears primarily in relation to implicit processing. ADHD groups show intermediate social cognition performance, appearing to be influenced by executive function difficulties. Social cognition varies with intellectual and verbal abilities and seems to improve with age in autism and ADHD. Social skills interventions in autism, and stimulant medication in ADHD have been shown to improve social cognition test performance, while mentalizing training effects in autism are less conclusive. A limitation of the field is that social cognition constructs and tests are not well delineated. Further, most research has been embedded in a nativist approach rather than a constructivist approach. The former has been questioned for ignoring environmental contributions, especially the dimension of mutual miscommunication between neurodivergent and neurotypical individuals.

Exploring sexual and romantic functioning as early risk factors of schizophrenia: a narrative review

Background

Patients with schizophrenia frequently encounter challenges related to sexuality and intimacy; however, the underlying causes of these difficulties remain unknown and unexplored.

Aim

This narrative review aims to explore how the biological/hormonal and psychological/behavioral developmental trajectories in schizophrenia patients deviate from the normal course and to examine their connection to difficulties in sexual and romantic functioning.

Methods

A comprehensive literature search was conducted using PubMed and Google Scholar, with key terms related to schizophrenia and sexual development without restriction on publication year. Articles discussing behavioral, sexual, or psychological/behavioral development before the onset of schizophrenia were included. Articles were divided into biological/hormonal and psychological/behavioral precursor categories. Additional searches were conducted to explore the broader sociocognitive context of schizophrenia, such as deficits in empathy, emotional processing, and theory of mind.

Outcomes

The review highlights deviations in both biological/hormonal and psychological/behavioral development in schizophrenia that contribute to difficulties in romantic and sexual relationships.

Results

This narrative review addresses the extent to which biological, psychological, and social factors in schizophrenia may be closely intertwined. Abnormalities in the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axes have been documented in individuals with schizophrenia, potentially impairing sociosexual competencies and leading to behavioral challenges in forming sexual relationships. Deficits in theory of mind, emotional processing, and empathy may further hinder the ability to form and sustain intimate relationships, amplifying the social difficulties associated with schizophrenia. Additionally, early life traumas, especially sexual abuse, can contribute to sexual difficulties and worsen the disorder.

Clinical Translation

Understanding the deviations from the normal developmental course in schizophrenia patients may offer valuable insights for potential intervention strategies and remediation approaches and contribute to improvements in sexual/romantic functioning and overall sexual health in schizophrenia patients.

Strengths and Limitations

This review provides an overview of the developmental precursors of schizophrenia-related sexual/romantic difficulties. Further research is needed to elucidate the specific mechanisms underlying these difficulties, particularly in determining the emotional and motivational salience of sexual stimuli and the capacity to engage in and maintain communication of sexual interest. The reader should bear in mind that narrative reviews lack systematic methods for selecting and evaluating studies, which can lead to author bias in choosing or interpreting sources.

Conclusion

The narrative review identified deviations in the biological/hormonal and psychological/behavioral developmental trajectories of schizophrenia patients, linking these abnormalities to difficulties in sexual and romantic functioning, and highlighting the need for sexological remediation strategies to improve sociosexual competencies and overall sexual health.

Tying Food Addiction to Uncontrolled Eating: The Roles of Eating-Related Thoughts and Emotional Eating

Background. Food addiction is often linked to overeating and difficulty in controlling eating habits. At the same time, food addiction is often associated with intense eating-related thoughts and emotional eating behaviors. However, despite extensive research on food addiction, the psychological processes that contribute to these outcomes have not been fully examined. Consequently, this study aims to fill that gap by investigating the influence of eating-related thoughts, as well as emotional eating behaviors that may precede episodes of uncontrolled eating. Methods. A cross-sectional design was used. A sample of 467 individuals was enrolled from the general population. Participants completed a battery of self-report questionnaires. A sequential mediation analysis with latent variables (i.e., structural equation modeling; SEM) using 5000 bootstrap samples and observed variables was performed. Results. The proposed model provides good fit indices. Indeed, food addiction predicts uncontrolled eating behaviors through eating-related thoughts (p < 0.001), which were also significantly associated with the emotion-driven eating patterns (p < 0.001), revealing a fully mediated model explaining 61.6% of the outcome variance (R2 = 0.616). Discussion. The findings underscore the critical influence of cognitive factors (i.e., eating-related thoughts) in driving maladaptive coping mechanisms like emotional eating. Moreover, emotional eating may act as a precursor to behaviors associated with overeating, which are often rooted in food addiction. Conclusions. Recognizing the central role of thoughts and emotions can help clinicians develop more targeted psychological interventions for those experiencing food addiction symptoms.

Low Versus High Levels of Social Cognition Impairment and Their Associations With Specific Schizophrenia Symptom Domains

OBJECTIVE

Social cognition is defined as the ability to construct mental representations about oneself, others, and one's relationships with others to guide social behaviors, including referring to mental states (cognitive factor) and understanding emotional states (affective factor). Difficulties in social cognition may be symptoms of schizophrenia. The authors examined associations between two factors of social cognition and specific schizophrenia symptoms, as well as a potential path from low-level affective perceptual social cognition to high-level social cognition, which may be associated with schizophrenia symptoms.

METHODS

The authors compared IQ, executive function, and social cognition scores of 41 patients with schizophrenia with those of a community-based group of 30 healthy individuals by using the Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version, the Movie for the Assessment of Social Cognition-Taiwan version, and the Chinese version of the theory of mind task.

RESULTS

In analyses controlled for IQ and executive function scores, patients with schizophrenia were found to perform more poorly than individuals in the healthy comparison group on all social cognition tasks. Disorganized symptoms were associated with lower accuracy of recognizing happy and angry faces, a lower verbal theory of mind score, and altered low- and high-level social cognition scores. A potential causal link was identified between low-level affective perceptual social cognition and high-level social cognition, resulting in disorganized symptoms.

CONCLUSIONS

These results indicate distinct roles of two factors of social cognition in schizophrenia symptomatology and provide a new direction for alleviating symptoms of this disorder by enhancing social cognition.

Relationship Between Cognitive Estimation, Executive Functions, and Theory of Mind in Patients With Prefrontal Cortex Damage

OBJECTIVE

Conflicting evidence has arisen from the few studies that have examined the role of the prefrontal cortex and executive control functions in theory of mind (ToM). Moreover, the involvement of other cognitive domains in the ability to infer mental states is still under debate. This study aims to examine, in addition to the potential contribution of executive functions, the role of cognitive estimation in ToM abilities, given that cognitive estimation processes are strongly associated with some aspects of executive control functions.

METHOD

The cognitive estimation task, along with a set of neuropsychological tasks assessing executive functions, was administered to 30 patients with prefrontal cortex damage and 30 control subjects matched by gender, age, and education level.

RESULTS

Patients with prefrontal cortex damage were impaired in all measures of executive functions, cognitive estimation, and theory of mind compared with control subjects. Regression analysis showed a significant interaction between executive measures and cognitive estimation in predicting ToM performance for patients with prefrontal cortex damage. Additionally, voxel-based lesion analysis identified a partially common bilaterally distributed prefrontal network involved in all three domains, centered within the ventral and dorsomedial areas with extension to the dorsolateral prefrontal cortex.

CONCLUSION

Our findings highlight that, apart from executive functions, cognitive estimation plays a crucial role in the ability to interpret others' cognitive and emotional states in both patients with prefrontal cortex damage and control subjects.

Meditation-Induced Self-Boundary Flexibility and Prosociality: A MEG and Behavioral Measures Study

BACKGROUND

In the last decade, empirical studies on the beneficial effects of meditation on prosocial capacities have accumulated, but the underlying mechanisms remain unclear. Buddhist sources state that liberating oneself from a fixed view of the self by gaining access to its transitory and malleable nature leads to increased compassion and other prosocial traits. These, however, have not yet been empirically tested.

METHODS

The current study aims at filling this gap by first examining whether 44 long term meditators differ from 53 controls in prosocial capacities on different levels of the socio-cognitive hierarchy, and second by examining whether these are associated with meditation-induced 'selfless' states, operationalized here as the sense of boundary (SB) flexibility. We capitalize on our previous work on the neurophenomenology of mindfulness-induced SB dissolution, which yielded a neural index of SB-flexibility, solely for the meditators, and examine its correlations with a battery of validated behavioral prosociality tasks.

RESULTS

Our findings reveal enhanced low-level prosocial processes in meditators, including enhanced emotion recognition and reduced outgroup bias. We show the stability of SB flexibility over a year, demonstrating consistent high beta deactivation. The neural index of SB flexibility negatively correlates with recognizing negative emotions, suggesting a link to reduced social threat perception.

CONCLUSIONS

These results connect the neural correlates of SB flexibility to prosociality, supported by stable high beta deactivations. We expect the results to raise awareness regarding the prosocial potential of flexing one's self-boundaries through meditation.

Reexamining the Kuleshov effect: Behavioral and neural evidence from authentic film experiments

Film cognition explores the influence of cinematic elements, such as editing and film color, on viewers' perception. The Kuleshov effect, a famous example of how editing influences viewers' emotional perception, was initially proposed to support montage theory through the Kuleshov experiment. This effect, which has since been recognized as a manifestation of point-of-view (POV) editing practices, posits that the emotional interpretation of neutral facial expressions is influenced by the accompanying emotional scene in a face-scene-face sequence. However, concerns persist regarding the validity of previous studies, often employing inauthentic film materials like static images, leaving the question of its existence in authentic films unanswered. This study addresses these concerns by utilizing authentic films in two experiments. In Experiment 1, multiple film clips were captured under the guidance of a professional film director and seamlessly integrated into authentic film sequences. 59 participants viewed these face-scene-face film sequences and were tasked with rating the valence and emotional intensity of neutral faces. The findings revealed that the accompanying fearful or happy scenes significantly influence the interpretation of emotion on neutral faces, eliciting perceptions of negative or positive emotions from the neutral face. These results affirm the existence of the Kuleshov effect within authentic films. In Experiment 2, 31 participants rated the valence and arousal of neutral faces while undergoing functional magnetic resonance imaging (fMRI). The behavioral results confirm the Kuleshov effect in the MRI scanner, while the neural data identify neural correlates that support its existence at the neural level. These correlates include the cuneus, precuneus, hippocampus, parahippocampal gyrus, post cingulate gyrus, orbitofrontal cortex, fusiform gyrus, and insula. These findings also underscore the contextual framing inherent in the Kuleshov effect. Overall, the study integrates film theory and cognitive neuroscience experiments, providing robust evidence supporting the existence of the Kuleshov effect through both subjective ratings and objective neuroimaging measurements. This research also contributes to a deeper understanding of the impact of film editing on viewers' emotional perception from the contemporary POV editing practices and neurocinematic perspective, advancing the knowledge of film cognition.

Insula uses overlapping codes for emotion in self and others

In daily life, we must recognize others' emotions so we can respond appropriately. This ability may rely, at least in part, on neural responses similar to those associated with our own emotions. We hypothesized that the insula, a cortical region near the junction of the temporal, parietal, and frontal lobes, may play a key role in this process. We recorded local field potential (LFP) activity in human neurosurgical patients performing two tasks, one focused on identifying their own emotional response and one on identifying facial emotional responses in others. We found matching patterns of gamma- and high-gamma band activity for the two tasks in the insula. Three other regions (MTL, ACC, and OFC) clearly encoded both self- and other-emotions, but used orthogonal activity patterns to do so. These results support the hypothesis that the insula plays a particularly important role in mediating between experienced vs. observed emotions.

Are organics more nutritious than conventional foods? A comprehensive systematic review

The growing consumer interest fueled by the belief in the superiority of organic foods raises questions about their actual nutritional superiority over conventional ones. This assumption remains a controversial issue. The present study addresses scientific evidence to clarify this controversy and provide relevant insights for informed decision-making regarding dietary choices. We collected 147 scientific articles containing 656 comparative analyses based on 1779 samples of 68 vegetable, fruit, and other (cereals, pulses, etc.) foods, 22 nutritional properties, and nine residues. Results show that in 191 (29.1%) comparisons, there were significant differences between organic and conventional foods. In a similar quantity of cases (190; 29.0%), there were divergences in the results since some studies reported significant differences while others did not. Finally, most of the comparative analyses (275; 41.9%) showed no significant difference between organic and conventional foods. Therefore, the results herein show no generalizable superiority of organic over conventional foods. Claims for nutritious advantages would eventually be applied to specific comparisons, depending on the food type and nutritional parameter.

tDCS of right-hemispheric Wernicke's area homologue affects contextual learning of novel lexicon

Numerous studies have shown robust evidence of the right hemisphere's involvement in the language function, for instance in the processing of intonation, grammar, word meanings, metaphors, etc. However, its role in lexicon acquisition remains obscure. We applied transcranial direct current stimulation (tDCS) over the right-hemispheric homologue of Wernicke's area to assess its putative involvement in the processing of different types of novel semantics. After receiving 15 min of anodal, cathodal, or sham (placebo) tDCS, three groups of healthy participants learnt novel concrete and abstract words in the context of short stories. Learning outcomes were assessed using a battery of tests immediately after this contextual learning session and 24 h later. As a result, an inhibitory effect of cathodal tDCS and a facilitatory effect of anodal tDCS were found for abstract word acquisition only. We also found a significant drop in task performance on the second day of the assessment for both word types in all the stimulation groups, suggesting no significant influence of tDCS on the post-learning consolidation of new memory traces. The results suggest an involvement of Wernicke's right-hemispheric counterpart in initial encoding (but not consolidation) of abstract semantics, which may be explained either by the right hemispheres direct role in processing lexical semantics or by an indirect impact of tDCS on contralateral (left-hemispheric) cortical areas through cross-callosal connections.

Evidence for a multidimensional account of cognitive and affective theory of mind: A state-trace analysis

Theory of mind (ToM) has been argued to be a multidimensional construct, with ToM inferences depending on distinct processes across affective and cognitive ToM tasks and across first-order cognitive and second-order cognitive ToM tasks. Behavioural evidence for a multidimensional account has primarily depended on dissociations identified via analysis of variance, a statistical approach insufficient for assessing dimensionality. Instead, state-trace analysis (STA) is a more appropriate statistical technique to uncover dimensionality. The current study first applied STA to two summary datasets that had previously identified key dissociations between cognitive and affective ToM; these reanalyses did not support a multidimensional account of ToM. Next, STA was applied to a more detailed dataset to reveal whether ToM is based on multiple processes in a sample of 115 older adults aged 60-85 years (M = 68.5, SD = 5.92, 61.7% female) with higher or lower emotion perception ability. Participants made ToM judgements about different social exchanges (e.g., sarcasm or lying). STA results supported a multidimensional account of ToM across first-order cognitive, second-order cognitive, and affective ToM subdomains. These results lay a more rigorous foundation for subsequent studies to further examine the dimensionality of ToM and to apply formal modelling, progressing the field's understanding and measurement of the cognitive processes driving ToM judgements.

Criminal behaviors: A theory of mind problem?

Theory of mind (ToM) has been addressed in relation to functional alterations of certain brain regions and their connections. The objective is to evaluate ToM in imprisoned criminal offenders and to analyze their relationship with the functions linked to the prefrontal cortex according to their expression in neuropsychological tests. The sample was composed of 52 subjects. 27 committed instrumental homicides and 25 crimes of sale and/or possession of narcotics. A control group was taken, 19 healthy subjects at liberty. The Faux-Pas (FP) and the Reading the Mind in the Eyes tests were used. A neuropsychological battery of executive functions and functions related to the frontal lobes and Hare's Psychopathy Checklist-Revised (PCL-R) was also applied. The criminal groups have comparable performances in all measures. The control group (in freedom) showed higher performance, with statistical significance, in the Faux-Pas test. Moderate negative correlations were found between the FP and the PCL-R. A distinction between affective and cognitive ToM could be affirmed, with people deprived of liberty presenting deficient functioning in the cognitive ToM test. This difference in performance could be linked to the disruptive event with the social norm and not so much with the violent homicide act itself.

Aging, cingulate cortex, and cognition: insights from structural MRI, emotional recognition, and theory of mind

The cingulate cortex is a limbic structure involved in multiple functions, including emotional processing, pain, cognition, memory, and spatial orientation. The main goal of this structural Magnetic Resonance Imaging (MRI) study was to investigate whether age affects the cingulate cortex uniformly across its anteroposterior dimensions and determine if the effects of age differ based on sex, hemisphere, and regional cingulate anatomy, in a large cohort of healthy individuals across the adult lifespan. The second objective aimed to explore whether the decline in emotional recognition accuracy and Theory of Mind (ToM) is linked to the potential age-related reductions in the pregenual anterior cingulate (ACC) and anterior midcingulate (MCC) cortices. We recruited 126 healthy participants (18-85 years) for this study. MRI datasets were acquired on a 4.7 T system. The cingulate cortex was manually segmented into the pregenual ACC, anterior MCC, posterior MCC, and posterior cingulate cortex (PCC). We observed negative relationships between the presence and length of the superior cingulate gyrus and bilateral volumes of pregenual ACC and anterior MCC. Age showed negative effects on the volume of all cingulate cortical subregions bilaterally except for the right anterior MCC. Most of the associations between age and the cingulate subregional volumes were linear. We did not find a significant effect of sex on cingulate cortical volumes. However, stronger effects of age were observed in men compared to women. This study also demonstrated that performance on an emotional recognition task was linked to pregenual ACC volume, whist the ToM capabilities were related to the size of pregenual ACC and anterior MCC. These results suggest that the cingulate cortex contributes to emotional recognition ability and ToM across the adult lifespan.

Loneliness is associated with mentalizing and emotion recognition abilities in schizophrenia, but only in a cluster of patients with social cognitive deficits

OBJECTIVE

Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia.

METHOD

Data from clinical, neurocognitive, and social cognitive assessments were pooled from two cross-national samples (Poland/USA) to examine potential predictors of loneliness in 147 patients with schizophrenia and 103 healthy controls overall. Furthermore, the relationship between social cognition and loneliness was explored in clusters of patients with schizophrenia differing in social cognitive capacity.

RESULTS

Patients reported higher levels of loneliness than healthy controls. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels.

CONCLUSIONS

We have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in individuals with schizophrenia.

Link between metacognition and social cognition in schizophrenia: a systematic review and meta-analysis

Introduction

Metacognition is the ability to reflect on one's own cognitive processes, monitor and regulate them to enhance mental performance. Social cognition involves the capacity to perceive and respond to social cues from others. The study of metacognition and social cognition is an expanding research field in psychiatry. Both domains are related to neurocognition, symptoms and psychosocial functioning in schizophrenia. Understanding the relationship between social cognition and metacognition may be pivotal for enhancing the treatment of cognitive symptoms in schizophrenia.

Methods

We conducted a PRISMA systematic review and meta-analysis on quantitative studies comparing metacognition to social cognitive outcomes in adult outpatients with a schizophrenia spectrum disorder. Reports were retrieved from the Medline, ScienceDirect and PsycINFO databases up to July 13th, 2023. Risk of bias was assessed with the Cochrane tool.

Results

Our review included 1,036 participants across 17 reports, with 12 reports included in the meta-analysis. We found a significant positive correlation (r = 0.28, 95% CI: [0.14, 0.41]) between social cognition and metacognition. Subgroup analyses indicated that metacognition was specifically associated with theory of mind, attribution, and emotion processing. Different patterns of correlations were observed according to the assessment of metacognition and its subdimensions.

Conclusion

Despite discrepancies among the included studies, no publication bias was detected. The results suggest that metacognition and social cognition are distinct but related constructs. Those processes should be assessed and treated together, along with neurocognition, in schizophrenia.

A new short version of the Facial expressions of emotion: Stimuli and tests (FEEST) including prototype and morphed emotional stimuli

The ability to recognize emotions from facial expressions plays an important role in social interaction. This study aimed to develop a short version of the FEEST as a brief instrument to measure emotion recognition ability by applying prototype and morphed emotional stimuli. Morphed emotional stimuli include mixed emotions. Overall, 68 prototypes and 32 morphed emotional expressions were presented to 138 participants for 1 s. A retest with 76 participants was conducted after 6 months. The results showed sufficient variance for the measurement of individual differences in emotion recognition ability. Accuracy varied between emotions and was highest for anger and happiness. Cronbach's α was, on average, 0.70 for prototypes and 0.67 for morphed stimuli. Test-retest reliability was 0.60 for prototypes and 0.62 for morphed stimuli. The new short version of the FEEST is a reliable test to measure emotion recognition.

The relation of depressive symptoms to theory of mind in adults

BACKGROUND

Theory of mind (ToM) is the ability to understand thoughts and feelings of others. Significant heterogeneity exists for the strength of the association between depression and ToM performance.

METHODS

To clarify these relations, two studies of depressed and nondepressed adults investigate cross-sectional associations of four latent depression factors (i.e., somatic symptoms, depressed affect, positive affect, and interpersonal problems) to two aspects of ToM (reasoning vs. decoding). Study 1 investigated associations between depression factors and reasoning ToM (N = 258), and Study 2 investigated associations between depression factors and decoding ToM (N = 219).

RESULTS

In Study 1, the interpersonal problems factor was negatively related to reasoning ToM, though in Study 2, no consistent associations emerged between depression and decoding ToM. Study 2 also replicated a novel approach to assessing valence with the Reading the Mind in the Eyes Test.

LIMITATIONS

This investigation was primarily limited by cross-sectional designs, self-report, and online delivery of measures.

CONCLUSIONS

Findings emphasize the heterogeneity of ToM as a construct and identify targets for clinical intervention, with specific focus on bolstering reasoning ToM skills.

Longitudinal assessment of social cognition in de novo Parkinson's disease patients and its relationship with dopaminergic innervation

BACKGROUND

Social Cognition (SC) has been scarcely studied in Parkinson's disease (PD), and findings in early disease are controversial. SC encompasses different capacities such as facial emotion recognition (FER); Theory of Mind (ToM), the ability to understand other people's intentions (cognitive-ToM) and emotions (affective-ToM); and self-monitoring, the ability to regulate one's own behavior in social contexts. A relationship between dopaminergic deficit and SC in PD has been suggested.

OBJECTIVES

To prospectively assess, over a two-year period, SC in newly diagnosed drug-naïve, cognitively normal and non-depressed PD patients. Furthermore, we aimed to evaluate the relationship between SC and Fluorodopa (Positron Emission Tomography) Ki uptake, which is a marker of dopaminergic depletion.

METHODS

We compared SC performance between 25 de novo PD patients and 20 healthy controls (HC), and within-patients at baseline and two-year follow-up. The SC assessment included FER, ToM, as well as self-monitoring measures. The relationship between SC and dopaminergic innervation was also assessed in patients.

RESULTS

SC scores did not differ between PD and HC groups at baseline, nor between baseline and follow-up evaluation in PD. A significant positive correlation between self-monitoring and Fluorodopa Ki uptake in the left pallidum in PD patients was found at baseline. At follow-up, ToM (stories) positively correlated with Fluorodopa Ki uptake in the right thalamus and the left putamen.

CONCLUSION

SC appears to be preserved in de novo PD and remains stable in the short-term. Although more evidence is needed, our results support a relationship between dopamine innervation in subcortical regions and SC.

The role of cognitive estimation in understanding the mental states of others

Previous studies have emphasized the critical role of the prefrontal cortex in cognitive estimation and theory of mind, however, none of them has questioned the possible role of cognitive estimation processes in understanding the mental states of others. In this study, we compared 30 patients with focal prefrontal cortex damage and 30 control subjects matched by gender, age, and education level on their performances on a cognitive estimation task and two tasks assessing theory of mind: the "Faux-Pas" task and the Reading the Mind in the Eyes task. The results showed that patients were significantly impaired compared with control subjects on both abilities of cognitive estimation and theory of mind. Moreover, regression analyses showed that performance on theory of mind was predicted by the scores on cognitive estimation. Finally, using voxel-based lesion analysis, we identified a partially common bilaterally distributed prefrontal network involved in both these domains centred within the ventral and dorsomedial areas with extension to the dorsolateral prefrontal cortex.

Affective Theory of Mind in Late Adulthood: The Role of Emotion Complexity and Social Relatedness

BACKGROUND

Age-related declines in adult affective theory of mind (AToM) have been discovered. However, AToM measures have not accounted for emotional state complexity involved in AToM. Measures have also not accounted for different types of relationships - friends versus strangers - for which AToM is employed, which is important considering the limited social networks of aging adults.

OBJECTIVE

We address these issues and examine the emotion complexity, social-relatedness, and contextual relevance in AToM across adult ages (18-89 years) using a new task and two well-established measures.

RESULTS

The new task displayed good structural fit and internal construct validity. Overall, an age-related decline in AToM was found along with an interaction between age and emotion complexity. For all ages, AToM performance was best for complex emotions. However, as age increased, there was more rapid decline in AToM for more complex emotions than for less complex ones. Surprisingly, AToM performance for strangers was better than for social companions.

CONCLUSION

The findings suggest age-related AToM declines are more nuanced than previously understood given that adult age differences are related to emotional state complexity. They indicate that the emotion complexity levels of basic, complex, and self-conscious should be included in AToM assessments. Implications for AToM tasks and development are discussed.

Mentalizing in a movie for the assessment of social cognition (MASC): the validation in a taiwanese sample

BACKGROUND

The present study evaluated the psychometrics properties of a sensitive video-based test used in the evaluation of mentalizing skills, that is, the Movie for the Assessment of Social Cognition-Taiwanese version (MASC-TW).

METHODS

We recruited two independent samples of nonclinical participants (N = 167) and adult patients with schizophrenia (N = 41). The MASC-TW and two other social cognition measures, namely the Chinese version of Theory of Mind task (ToM) and the Taiwanese version of the Diagnostic Analysis of Nonverbal Accuracy-2 (DANAV-TW-2), and an executive function measure of the Wisconsin Card Sorting Test (WCST), were administered to both groups.

RESULTS

The MASC proved to be a reliable measure of mentalizing capacity, high Cronbach's α value of 0.87. The intraclass correlation coefficient for the MASC-TW total correct scores was 0.85 across three waves of data collection. Across the entire sample, the scores on the MASC-TW were significantly correlated with verbal and nonverbal scores for the ToM task and recognition of facial and prosodic emotion on the DANAV-TW-2. Both executive function and emotion recognition emerged as noteworthy predictors of mentalizing, indicating that these two variables might play crucial roles in the development of mentalizing capacities. Finally, a receiver operating characteristic analysis revealed that in patients with schizophrenia, the MASC was the most accurate discriminator of diagnostic groups, highlighting the validity of the MASC.

CONCLUSIONS

Overall, the MASC-TW is an ecologically valid and useful tool for assessing mentalizing abilities in a Taiwanese population.

A 20-Year Systematic Review of the 'Reading the Mind in the Eyes' Test across Neurodegenerative Conditions

Social cognition has a broad theoretical definition, which includes the ability to mentalise, i.e., recognise and infer mental states to explain and predict another's behaviour. There is growing recognition of the clinical, diagnostic, and prognostic value of assessing a person's ability to perform social cognitive tasks, particularly aspects of theory of mind, such as mentalising. One such measure of mentalising is the 'Reading the Mind in the Eyes' test (RMET). This systematic review and meta-analysis consider performance on the RMET, applied to people with neurodegenerative conditions in matched control studies, since its publication in 2001. Overall, this review includes 22 papers with data from N = 800 participants with neurodegenerative conditions: Alzheimer's disease, n = 31; Parkinson's disease, n = 221; Lewy body dementia, n = 33; motor neuron disease, n = 218; Huntington's disease n = 80; multiple sclerosis, n = 217; and N = 601 matched typical controls. Our meta-analyses show that deficits in mentalising, as measured by the RMET, are consistently reported across neurodegenerative conditions, with participants in both early and late disease stages being affected. Social cognition is an emerging field of cognitive neuroscience requiring specific and sensitive measurement across each subdomain. Adult-based meta-normative data feature, for which future groups or individuals could be compared against, and hypotheses relating to the source of these mentalising deficits are further discussed. This review was registered with PROSPERO (CRD42020182874).

Effectiveness of training in expressing positive emotions, reacting to change and greeting peers after childhood traumatic brain injury: a single-case experimental study

Background

Social cognitive deficits are common after traumatic brain injury (TBI). The participant in this single-case experimental design (SCED) was 7 years old when he sustained a severe TBI. After 2 years in rehabilitation, he continues to show deficits in social cognition.

Objective

To determine the effectiveness of three interventions, each aimed at improving a behavior altered by social cognition deficits. These behaviors were: (1) expression of positive emotions, (2) reacting to changes in plans, and (3) greeting classmates.

Method

An A-B-A' design was used for each behavior. In addition, each behavior was targeted with a rehabilitation program applied over 10 sessions.

Results

For the first behavior, changes between phases B-A' (NAP = 0.712) and A-A' (NAP = 0.864) indicated improvements in the child's ability to express positive emotions. In the second behavior, changes in the intensity of reactions between phases B and A' (NAP = 0.815) and A vs. A' (NAP = 0.834) indicated that the child adapted to changes in a plan and to unexpected situations in a more adaptive way. For the third behavior, changes in the number of greetings between phases A and B (NAP = 0.883) and A vs. A' (NAP = 0.844) suggested that during the third phase of the study, the participant fully acquired the habit of greeting peers and increased his interactions with others.

Conclusion

While the participant showed improvements in all three targeted behaviors, due to the complexity of the third behavior, it is recommended that in future research, the intervention targeting social interactions should be applied over a longer timeframe to ensure that improvements are more stable in the long term.

The role of the prefrontal cortex in social interactions of animal models and the implications for autism spectrum disorder

Social interaction is a complex behavior which requires the individual to integrate various internal processes, such as social motivation, social recognition, salience, reward, and emotional state, as well as external cues informing the individual of others' behavior, emotional state and social rank. This complex phenotype is susceptible to disruption in humans affected by neurodevelopmental and psychiatric disorders, including autism spectrum disorder (ASD). Multiple pieces of convergent evidence collected from studies of humans and rodents suggest that the prefrontal cortex (PFC) plays a pivotal role in social interactions, serving as a hub for motivation, affiliation, empathy, and social hierarchy. Indeed, disruption of the PFC circuitry results in social behavior deficits symptomatic of ASD. Here, we review this evidence and describe various ethologically relevant social behavior tasks which could be employed with rodent models to study the role of the PFC in social interactions. We also discuss the evidence linking the PFC to pathologies associated with ASD. Finally, we address specific questions regarding mechanisms employed by the PFC circuitry that may result in atypical social interactions in rodent models, which future studies should address.

Performance in emotion recognition and theory of mind tasks in social anxiety and generalized anxiety disorders: a systematic review and meta-analysis

Social cognition impairments may be associated with poor functional outcomes, symptoms, and disability in social anxiety disorder (SAD) and generalized anxiety disorder (GAD). This meta-analysis aims to determine if emotion recognition and theory of mind (ToM) are impaired in SAD or GAD compared to healthy controls. A systematic review was conducted in electronic databases (PubMed, PsycNet, and Web of Science) to retrieve studies assessing emotion recognition and/or ToM in patients with SAD or GAD, compared to healthy controls, up to March 2022. Meta-analyses using random-effects models were conducted. We identified 21 eligible studies: 13 reported emotion recognition and 10 ToM outcomes, with 585 SAD patients, 178 GAD patients, and 753 controls. Compared to controls, patients with SAD exhibited impairments in emotion recognition (SMD = -0.32, CI = -0.47 - -0.16, z = -3.97, p < 0.0001) and ToM (SMD = -0.44, CI = -0.83 -0.04, z = -2.18, p < 0.01). Results for GAD were inconclusive due to the limited number of studies meeting the inclusion criteria (two for each domain). Relevant demographic and clinical variables (age, sex, education level, and anxiety scores) were not significantly correlated with emotion recognition or ToM impairments in SAD and GAD. Further studies employing ecological measures with larger and homogenous samples are needed to better delineate the factors influencing social cognition outcomes in both SAD and GAD.

Psychopathic Traits and Theory of Mind Task Performance: A Systematic Review and Meta-analysis

This meta-analysis aims to examine the relationship between psychopathic traits and theory of mind (ToM), which is classically and broadly defined as competency in representing and attributing mental states such as emotions, intentions, and beliefs to others. Our search strategy gathered 142 effect sizes, from 42 studies, with a total sample size of 7463 participants. Random effects models were used to analyze the data. Our findings suggested that psychopathic traits are associated with impaired ToM task performance. This relationship was not moderated by age, population, psychopathy measurement (self-report versus clinical checklist) or conceptualization, or ToM task type (cognitive versus affective). The effect also remained significant after excluding tasks that did not require the participant to 1) mentalize or 2) differentiate self and other perspectives. However, interpersonal/affective traits were associated with a more pronounced impairment in ToM task performance compared to lifestyle/antisocial traits. Future research should investigate the effects of distinct psychopathy facets that will allow for a more precise understanding of the social-cognitive bases of relevant clinical presentations in psychopathy.

Boosting the Theory of Mind Network: Specific Psychotherapy Increases Neural Correlates of Affective Theory of Mind in Euthymic Bipolar Disorder

BACKGROUND

In bipolar disorder, impaired affective theory of mind (aToM) performance and aberrant neural activation in the ToM brain network partly explain social functioning impairments. However, it is not yet known whether psychotherapy of bipolar disorder influences neuroimaging markers of aToM.

METHODS

In this study, conducted within the multicentric randomized controlled trial of the BipoLife consortium, patients with euthymic bipolar disorder underwent 2 group interventions over 6 months (mean = 28.45 weeks): 1) a specific, cognitive behavioral intervention (specific psychotherapeutic intervention [SEKT]) (n = 31) targeting impulse regulation, ToM, and social skills and 2) an emotion-focused intervention (FEST) (n = 28). To compare the effect of SEKT and FEST on neural correlates of aToM, patients performed an aToM task during functional magnetic resonance imaging before and after interventions (final functional magnetic resonance imaging sample of pre- and postcompleters, SEKT: n = 16; FEST: n = 17). Healthy control subjects (n = 32) were scanned twice with the same time interval. Because ToM was trained in SEKT, we expected an increased ToM network activation in SEKT relative to FEST postintervention.

RESULTS

Both treatments effectively stabilized patients' euthymic state in terms of affective symptoms, life satisfaction, and global functioning. Confirming our expectations, SEKT patients showed increased neural activation within regions of the ToM network, bilateral temporoparietal junction, posterior cingulate cortex, and precuneus, whereas FEST patients did not.

CONCLUSIONS

The stabilizing effect of SEKT on clinical outcomes went along with increased neural activation of the ToM network, while FEST possibly exerted its positive effect by other, yet unexplored routes.

Trait absorption predicts enhanced face emotion intensity discrimination among military recruits

Accurate emotion perception is an indicator of current psychosocial functioning. Past studies have reported variable relationships between impaired emotion identification, maladaptive personality traits, and psychopathology. We examined associations between discrimination performance and trait negative emotionality, positive emotionality, constraint, and absorption using the Multidimensional Personality Questionnaire. New military soldiers (n = 548) viewed perceptually similar face pairs and picked the face with greater emotional intensity. Emotional intensity differences were small (10%, 20%, 30%, or 40%). Among the most ambiguous conditions (10%, 20%, 30%), absorption predicted higher accuracy. Negative emotionality predicted lower accuracy irrespective of percent difficulty. Furthermore, absorption predicted longer engagement during the 10% condition. Constraint predicted longer engagement regardless of the difficulty condition. Trait absorption accuracy effects were specific for sad, angry, and fearful faces, while negative emotionality accuracy effects were specific for sad faces. The findings highlight absorption as an underappreciated domain for explaining motivational engagement with faces and negative emotionality as a transdiagnostic predictor of impaired emotion perception.

Null results of oxytocin and vasopressin administration on mentalizing in a large fMRI sample: evidence from a randomized controlled trial

BACKGROUND

Although potential links between oxytocin (OT), vasopressin (AVP), and social cognition are well-grounded theoretically, most studies have included all male samples, and few have demonstrated consistent effects of either neuropeptide on mentalizing (i.e. understanding the mental states of others). To understand the potential of either neuropeptide as a pharmacological treatment for individuals with impairments in social cognition, it is important to demonstrate the beneficial effects of OT and AVP on mentalizing in healthy individuals.

METHODS

In the present randomized, double-blind, placebo-controlled study (n = 186) of healthy individuals, we examined the effects of OT and AVP administration on behavioral responses and neural activity in response to a mentalizing task.

RESULTS

Relative to placebo, neither drug showed an effect on task reaction time or accuracy, nor on whole-brain neural activation or functional connectivity observed within brain networks associated with mentalizing. Exploratory analyses included several variables previously shown to moderate OT's effects on social processes (e.g., self-reported empathy, alexithymia) but resulted in no significant interaction effects.

CONCLUSIONS

Results add to a growing literature demonstrating that intranasal administration of OT and AVP may have a more limited effect on social cognition, at both the behavioral and neural level, than initially assumed. Randomized controlled trial registrations: ClinicalTrials.gov; NCT02393443; NCT02393456; NCT02394054.

Little brain, little minds: The big role of the cerebellum in social development

Seminal work in the 1990's found alterations in the cerebellum of individuals with social disorders including autism spectrum disorder and schizophrenia. In neurotypical populations, distinct portions of the posterior cerebellum are consistently activated in fMRI studies of social cognition and it has been hypothesized that the cerebellum plays an essential role in social cognition, particularly in theory of mind. Here we review the lesion literature and find that the effect of cerebellar damage on social cognition is strongly linked to the age of insult, with dramatic impairments observed after prenatal insult, strong deficits observed after childhood damage, and mild and inconsistent deficits observed following damage to the adult cerebellum. To explain the developmental gradient, we propose that early in life, the forward model dominates cerebellar computations. The forward model learns and uses errors to help build schemas of our interpersonal worlds. Subsequently, we argue that once these schemas have been built up, the inverse model, which is the foundation of automatic processing, becomes dominant. We provide suggestions for how to test this, and also outline directions for future research.

Developing and Validating a Facial Emotion Recognition Task With Graded Intensity

Facial emotion recognition (FER) tasks are often digitally altered to vary expression intensity; however, such tasks have unknown psychometric properties. In these studies, an FER task was developed and validated-the Graded Emotional Face Task (GEFT)-which provided an opportunity to examine the psychometric properties of such tasks. Facial expressions were altered to produce five intensity levels for six emotions (e.g., 40% anger). In Study 1, 224 undergraduates viewed subsets of these faces and labeled the expressions. An item selection algorithm was used to maximize internal consistency and balance gender and ethnicity. In Study 2, 219 undergraduates completed the final GEFT and a multimethod battery of validity measures. Finally, in Study 3, 407 undergraduates oversampled for borderline personality disorder (BPD) completed the GEFT and a self-report BPD measure. Broad FER scales (e.g., overall anger) demonstrated evidence of reliability and validity; however, more specific subscales (e.g., 40% anger) had more variable psychometric properties. Notably, ceiling/floor effects appeared to decrease both internal consistency and limit external validity correlations. The findings are discussed from the perspective of measurement issues in the social cognition literature.

Social perception in children and adolescents with ADHD: The role of higher-order cognitive skills

Despite children with ADHD frequently experiencing difficulties in social perception, the mechanisms underlying this impairment have been poorly explored. In this study, we examined social perception in children with ADHD, comparing them with typically-developing (TD) children on semi-naturalistic tasks, and considering the effect of nonverbal signal recognition. Our aim was to ascertain whether the two groups' social perception related to different types of stimulus (video, audio or combined/multimodal). The role of three higher-order cognitive skills (theory of mind, attention and pragmatic language) was also investigated. Thirty-six children with ADHD, and 36 TD controls were tested. Social perception was significantly associated with participants' ability to recognize nonverbal signals, and with the stimulus presentation modality. Children with ADHD only performed less well than TD children with combined stimuli. As concerns the higher-order cognitive skills, theory of mind had a significant role in both groups, but only with the video and combined stimuli, while attention explained most of the variance in social perception for all types of stimulus. Better pragmatic language skills were only associated with a better social perception in TD children, whatever the type of stimulus presented. Semi-naturalistic tasks should be included when assessing social perception in ADHD, and both theory of mind and attention should be the object of efforts to enhance social perception in the ADHD population.

Automatic and controlled attentional orienting toward emotional faces in patients with Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative motor disorder that can associate with deficits in cognitive and emotional processing. In particular, PD has been reported to be mainly associated with defects in executive control and orienting attentional systems. The deficit in emotional processing mainly emerged in facial expression recognition. It is possible that the defects in emotional processing in PD may be secondary to other cognitive impairments, such as attentional deficits. This study was designed to systematically investigate the different weight of automatic and controlled attentional orienting mechanisms implied in emotional selective attention in PD. To address our purpose, we assessed drug-naïve PD patients and age-matched healthy controls with two dot-probe tasks that differed for stimuli duration. Automatic and controlled attentions were evaluated with stimuli lasting 100 ms and 500 ms, respectively. Furthermore, we introduced an emotion recognition task to investigate the performance in explicit emotion classification. The stimuli used in both the tasks dot-probe and emotion recognition were expressive faces displaying neutral, disgusted, fearful, and happy expressions.Our results showed that in PD patients, compared with healthy controls, there was 1) an alteration of automatic and controlled attentional orienting toward emotional faces in both the dot-probe tasks (with short and long durations), and 2) no difference in the emotion recognition task. These findings suggest that, from the early stages of the disease, PD can yield specific deficits in implicit emotion processing task (i.e., dot-probe task) despite a normal performance in explicit tasks that demand overt emotion recognition.

The neural basis of smile authenticity judgments and the potential modulatory role of the oxytocin receptor gene (OXTR)

Accurate perception of genuine vs. posed smiles is crucial for successful social navigation in humans. While people vary in their ability to assess the authenticity of smiles, little is known about the specific biological mechanisms underlying this variation. We investigated the neural substrates of smile authenticity judgments using functional magnetic resonance imaging (fMRI). We also tested a preliminary hypothesis that a common polymorphism in the oxytocin receptor gene (OXTR) rs53576 would modulate the behavioral and neural indices of accurate smile authenticity judgments. A total of 185 healthy adult participants (Neuroimaging arm: N = 44, Behavioral arm: N = 141) determined the authenticity of dynamic facial expressions of genuine and posed smiles either with or without fMRI scanning. Correctly identified genuine vs. posed smiles activated brain areas involved with reward processing, facial mimicry, and mentalizing. Activation within the inferior frontal gyrus and dorsomedial prefrontal cortex correlated with individual differences in sensitivity (d') and response criterion (C), respectively. Our exploratory genetic analysis revealed that rs53576 G homozygotes in the neuroimaging arm had a stronger tendency to judge posed smiles as genuine than did A allele carriers and showed decreased activation in the medial prefrontal cortex when viewing genuine vs. posed smiles. Yet, OXTR rs53576 did not modulate task performance in the behavioral arm, which calls for further studies to evaluate the legitimacy of this result. Our findings extend previous literature on the biological foundations of smile authenticity judgments, particularly emphasizing the involvement of brain regions implicated in reward, facial mimicry, and mentalizing.

Neural responses to monetary incentives in postpartum women affected by baby blues

Up to 50% of new mothers experience baby blues (BB) within a week of delivery, with affective disturbances being the central symptoms. Because reward processing is known to be affected in depression, this study sought to investigate whether incentive processing during the experience of BB can be altered through the monetary incentive delay (MID) task. The MID task allows reward processing to be investigated based on responses to 'anticipation' and 'feedback of reward or loss'. 60 women participated in the fMRI-based MID task within 1-6 days of delivery, and 50% of them developed BB within the first few postpartum weeks. Over a 12-week observation period, a greater number of women in the BB group (52% vs. 13%) developed psychiatric conditions, with 24% of women with BB developing postpartum depression compared to only 3% of those without BB. During the feedback trials of the MID task, women with BB, compared to those without, showed increased activation in both the winning and losing trials (the temporal areas, the insula, the midbrain, and the inferior frontal gyrus). During the anticipation trials, however, subjects affected by BB showed reduced activation in the pregenual and the subgenual anterior cingulate cortices (pg/sg ACC). Our results demonstrate, for the first time, that the BB-related time window overlaps with alterations in the brain networks associated with incentive processing. Given the involvement of pg/sgACC in the development of depressive mood, the weaker involvement of these brain regions during anticipation in participants affected by BB is of particular interest.

Characteristics of Odor Identification and Hedonics and Their Association with Piriform Cortex-Based Resting-State Functional Connectivity in Amnestic Mild Cognitive Impairment

BACKGROUND

Olfactory identification dysfunction (OID) might be an early sign of amnestic mild cognitive impairment (aMCI). However, odor hedonics, the ability to perceive odor pleasantness, is neglected. Also, the neural substrate of OID remains unclear.

OBJECTIVE

To explore the characteristics of odor identification and hedonics in aMCI and examine the potential neural correlates of OID by analyzing olfactory functional connectivity (FC) patterns in MCI.

METHODS

Forty-five controls and 83 aMCI patients were examined. The Chinese smell identification test was used to assess olfaction. Global cognition, memory, and social cognition were assessed. Resting-state functional networks associated with olfactory cortex seeds were compared between the cognitively normal (CN) and aMCI groups, as well as between aMCI subgroups by the degree of OID.

RESULTS

Compared to controls, aMCI patients had a significant deficit in olfactory identification, mainly reflected in the identification of pleasant and neutral odors. aMCI patients also rated pleasant and neutral odors much lower than controls. A positive correlation between olfaction and social cognition was found in aMCI. The seed-based FC analysis found that aMCI patients had higher FC between the right orbitofrontal cortex and right frontal lobe/middle frontal gyrus than controls. Subgroup analysis showed that, compared to aMCI without OID, aMCI with severe OID had abnormal FC in the bilateral piriform region.

CONCLUSION

Our results suggest that OID in aMCI primarily refers to the identification of pleasant and neutral odors. The FC alterations in bilateral orbitofrontal cortex and piriform cortices might contribute to the impairment in odor identification.

Comparing gratitude and pride: evidence from brain and behavior

Gratitude and pride are both positive emotions. Yet gratitude motivates people to help others and build up relationships, whereas pride motivates people to pursue achievements and build on self-esteem. Although these social outcomes are crucial for humans to be evolutionarily adaptive, no study so far has systematically compared gratitude and pride to understand why and how they can motivate humans differently. In this review, we compared gratitude and pride from their etymologies, cognitive prerequisites, motivational functions, and brain regions involved. By integrating the evidence from brain and behavior, we suggest that gratitude and pride share a common reward basis, yet gratitude is more related to theory of mind, while pride is more related to self-referential processing. Moreover, we proposed a cognitive neuroscientific model to explain the dynamics in gratitude and pride under a reinforcement learning framework.

Toward social neuropsychology of epilepsy: a meta-analysis on social cognition in epilepsy phenotypes and a critical narrative review on assessment methods

Background

The aim of this review is to (a) characterize social cognition impairments in the domains of emotion recognition (ER) and theory of mind (ToM) in patients with epilepsy and (b) to review assessment tools with a focus on their validity and usability in clinical practice.

Methods

An electronic search for clinical studies investigating social cognition in epilepsy populations vs healthy control subjects (HC) yielded 53 studies for the meta-analysis and descriptive review.

Results

Results suggest that (1) social cognition is significantly impaired in patients with temporal lobe epilepsy (TLE), frontal lobe epilepsy (FLE) and patients with epilepsy not originating within the temporal or frontal lobes including idiopathic generalized epilepsies (eTLE/eFLE); (2) there is no significant difference between eTLE/eFLE and TLE regarding ER, while TLE and FLE patients perform worse than those with eTLE/eFLE, without significant differences between FLE and TLE regarding ToM ability. A descriptive analysis of the most commonly used assessment tools and stimulus material in this field revealed a lack of ecological validity, usability, and economic viability for everyday clinical practice.

Conclusions

Our meta-analysis shows that patients with epilepsy are at a significantly increased risk of deficits in social cognition. However, the underlying multifactorial mechanisms remain unclear. Future research should therefore specifically address the impairment of processing and methodological problems of testing.

Age differences in social-cognitive abilities across the stages of adulthood and path model investigation of adult social cognition

Accumulating evidence points toward an association between older age and performance decrements in social cognition (SC). We explored age-related variations in four components of SC: emotion recognition, theory of mind, social judgment, and blame attributions. A total of 120 adults divided into three stages (18-34 years, 35-59 years, 60-85 years) completed a battery of SC. Between and within age-group differences in SC were investigated. Path analyses were used to identify relationships among the components. Emotion recognition and theory of mind showed differences beginning either in midlife, or after. Blame attributions and social judgment did not show a significant difference. However, social judgment varied significantly within groups. Path models revealed a relationship between emotion recognition and theory of mind. Findings highlight age-related differences in some components and a link between two components. Strategies promoting social functioning in aging might help to maintain or improve these abilities over time.

Mentalizing abilities mediate the impact of the basic social perception on negative symptoms in patients with schizophrenia

Social cognitive deficits are currently considered as one of the main predictors of clinical symptoms and functional outcome in patients with schizophrenia. Multiple studies have suggested that a two-factor solution (low-level vs. high-level) best describes the structure of social cognitive processes in patients. While higher-order processes have been repeatedly linked to negative symptoms, no such association was found for lower-level processes. Thus, the aim of the current study is to examine whether the association between basic social perception processes and symptoms in patients with schizophrenia is mediated by mentalizing abilities. One hundred thirty-nine patients have completed basic social perception (Communicative Interactions Database task CID-12) and mentalizing (Reading the Mind in the Eyes task) tasks. In line with our hypothesis, we have observed full mediation of the effects of basic social perception abilities on negative symptoms via mentalizing abilities in patients. This effect suggests that, similarly as in the case of positive symptoms, a hierarchical nature of social cognitive processes should be considered while investigating negative symptoms of schizophrenia.

Association of Cardiovascular Risk Markers and Fitness with Task-Related Neural Activity during Animacy Perception

PURPOSE

Numerous studies have demonstrated the association between cardiovascular risk markers and fitness, and broad aspects of cognition; however, the possible association of cardiovascular risk markers and fitness with social cognition, which plays a significant role in the development and maintenance of social relationships, has largely been ignored. Herein, we investigated the relationship of cardiovascular risk markers and fitness with task-related neural activity during animacy perception.

METHODS

We analyzed data from the Human Connectome Project derived from 1027 adults age 22-37 yr. Canonical correlation analysis (CCA) was conducted to evaluate the association between participants' body mass index, systolic and diastolic blood pressure, submaximal endurance, gait speed, hand dexterity, and muscular strength with task-related neural activity during animacy perception.

RESULTS

We observed a single significant CCA mode. Body mass index and blood pressure demonstrated negative cross-loadings with task-related neural activity in the temporoparietal, superior and anterior temporal, posterior cingulate, and inferior frontal regions, whereas submaximal endurance, hand dexterity, and muscular strength demonstrated positive cross-loadings. The observed CCA variates did not seem highly heritable, as the absolute differences in CCA variates in monozygotic twins, dizygotic twins, and nontwin siblings were not statistically different. Furthermore, the cardiovascular risk markers and fitness CCA variates were positively associated with animacy perception and emotion recognition accuracy, which was mediated by the task-related neural activity.

CONCLUSIONS

The present findings can provide new insights into the role of markers for cardiovascular health and fitness, specifically their association with social cognition and the underlying neural basis. The intervention for cardiovascular risk and fitness could be a potentially cost-effective method of targeting social cognition.

Recognition of Facial Expressions of Emotion and Depressive Symptoms among Caregivers with Different Levels of Empathy

OBJECTIVES

To assess differences in the recognition of facial expressions of emotion among caregivers of older people with different levels of empathy.

METHODS

A cross-sectional study was conducted with 158 caregivers of older adults who provided care in family residences or nursing homes. The caregivers were divided into three groups based on the score of the multidimensional Interpersonal Reactivity Index: "lower empathy", "intermediate empathy", and "higher empathy". Data collection involved the administration of a sociodemographic questionnaire, the Emotion Recognition Test, and the Patient Health Questionnaire.

RESULTS

No significant differences were found among the groups in terms of sociodemographic variables. Regarding clinical characteristics, the "higher empathy" group had more depressive symptoms than the other groups (p = .001). Moreover, the "higher empathy" group exhibited greater accuracy at recognizing the expression of sadness than the "lower empathy" group (p = .033). The recognition of sadness remained significant in the analysis of variance adjusted for depressive symptoms (p < .05).

CONCLUSIONS

Caregivers with higher levels of empathy showed greater accuracy at recognizing sadness emotion compared to caregivers with lower levels of empathy. Additionally, caregivers with greater empathy have more depressive symptoms.

CLINICAL IMPLICATIONS

The recognition of facial expressions of sadness may give caregivers a skill to infer possible needs in older care recipients. However, a higher level of empathy may exert a negative psychological impact on caregivers of older people, which could have repercussions regarding the quality of care provided.

Domains and measures of social cognition in acquired brain injury: A scoping review

In acquired brain injury (ABI), social cognition is a contributing factor to the changes observed in functional outcomes. However, progress in assessing and understanding social cognitive impairments is limited by a lack of consistency in terminology and the proliferation in assessment tools, leading to a lack of consensus on what should be assessed and how. This review aims to examine the domains of social cognition commonly assessed in ABI, the assessment tools used, and the appropriateness of these tools for researchers and clinicians. Using the Arksey and O'Malley scoping review methodology, 367 articles reporting results from 10,930 people with an ABI met our inclusion criteria. The five most commonly assessed domains of social cognition were emotion perception, theory of mind, social communication, identity recognition and empathy. The most commonly used measure of these domains included: the Ekman and Friesen photo series, Faux Pas Recognition Test, La Trobe Communication Questionnaire, Benton Facial Recognition Test and the Interpersonal Reactivity Index. There are well-validated measures readily available that are underused in favour of non-standardized measures clinically or the development of one's own measure in research. The appropriateness of the identified measure for research and clinical use was discussed, including suggestions for future research.

The expectant brain-pregnancy leads to changes in brain morphology in the early postpartum period

There is growing evidence that pregnancy may have a significant impact on the maternal brain, causing changes in its structure. To investigate the patterns of these changes, we compared nulliparous women (n = 40) with a group of primiparous women (n = 40) and multiparous mothers (n = 37) within 1-4 days postpartum, using voxel-based and surface-based morphometry (SBM). Compared with the nulliparous women, the young mothers showed decreases in gray matter volume in the bilateral hippocampus/amygdala, the orbitofrontal/subgenual prefrontal area, the right superior temporal gyrus and insula, and the cerebellum. These pregnancy-related changes in brain structure did not predict the quality of mother-infant attachment at either 3 or 12 weeks postpartum nor were they more pronounced among the multiparous women. SBM analyses showed significant cortical thinning especially in the frontal and parietal cortices, with the parietal cortical thinning likely potentiated by multiple pregnancies. We conclude that, compared with the brain of nulliparous women, the maternal brain shows widespread morphological changes shortly after childbirth. Also, the experience of pregnancy alone may not be the underlying cause of the adaptations for mothering. As regards the exact biological function of the changes in brain morphology, longitudinal research will be needed to draw any definitive conclusions.

Relationship of neurocognitive ability, perspective taking, and psychoticism with hostile attribution bias in non-clinical participants: Theory of mind as a mediator

Objectives

Hostile attribution bias is reportedly common from non-clinical population to those with serious mental illness, such as schizophrenia, and is known to be closely related to theory of mind (ToM). This study aimed to investigate whether ToM skills mediate the relationship among neurocognitive ability, personality traits, and attribution bias.

Methods

A total of 198 (101 females) non-clinical youths were recruited. To assess their neurocognitive ability and ToM skills, the participants were asked to complete Raven’s Standard Progressive Matrices (SPM) and the Korean version of the Reading the Mind in Eyes Test (K-RMET). To determine their personality traits, the Eysenck Personality Questionnaire (psychoticism) and interpersonal reactivity index (perspective taking) were used. To evaluate hostile attribution bias, the Ambiguous Intentions Hostility Questionnaire was administered. Path analysis and bias-corrected percentile bootstrap methods were used to estimate model fit and the parameters of the mediating effects.

Results

Based on model comparison, the best model characterized (1) two direct pathways from psychoticism and the K-RMET to hostility attribution bias and (2) three indirect pathways, wherein SPM, perspective taking, and psychoticism influenced hostile attribution bias through K-RMET. The final model fit indices were good [x²/df = 1.126; comparative fit index = 0.996; root mean square error of approximation = 0.026; standard root mean square residual = 0.026 and Akaike information criterion = 28.251] and the K-RMET fully mediated the association between SPM, perspective taking, psychoticism, and hostile attribution bias.

Conclusion

The main findings suggested that ToM skills, such as the RMET, play an important role in explaining the relationship among neurocognitive ability, personality traits, and hostile attribution bias. ToM skills and a remediation strategy may need to be developed to balance the enhanced hostility bias that underlies the paranoia.

Theory of mind in schizophrenia: a comparison of subgroups with low and high IQ

BACKGROUND

Social cognitive impairment is common in schizophrenia, but it is unclear if it is present in individuals with high IQ. This study compared theory of mind (ToM) in schizophrenia participants with low or high IQ to healthy controls.

METHODS

One hundred and nineteen participants (71 healthy controls, 17 high IQ (IQ ≥115), and 31 low IQ (IQ ≤95) schizophrenia participants) were assessed with the Movie for the Assessment of Social Cognition, providing scores for total, cognitive, and affective ToM, along with overmentalizing, undermentalizing, and no-mentalizing errors. IQ was measured with Wechsler Abbreviated Scale of Intelligence; clinical symptoms with the Positive and Negative Syndrome Scale.

RESULTS

Healthy controls performed better than the low IQ schizophrenia group for all ToM scores, and better than the high IQ schizophrenia group for the total score and under- and no-mentalizing errors. The high IQ group made fewer overmentalizing errors and had better total and cognitive ToM than the low IQ group. Their number of overmentalizing errors was indistinguishable from healthy controls.

CONCLUSION

Global ToM impairment was present in the low IQ schizophrenia group. Overmentalizing was not present in the high IQ group and appears related to lower IQ. Intact higher-level reasoning may prevent the high IQ group from making overmentalizing errors, through self-monitoring or inhibition. We propose that high IQ patients are chiefly impaired in lower-level ToM, whereas low IQ patients also have impaired higher-level ToM. Conceivably, this specific impairment could help explain the lower functioning reported in persons with intact IQ.

The association between language and recognition of facial emotional expressions in elderly individuals

PURPOSE

To check the association between a good performance of language and the recognition of facial emotional expressions in elderly individuals.

METHODS

Transversal study performed with 118 elderly individuals from the primary care services of health of a city in the state of São Paulo. Sociodemographic data were collected, regarding the performance of language through the domain of Addenbrooke Cognitive Examination - Revised and Recognition of Facial Emotional Expressions. The sample was divided in thirds according to the performance of language: T1 = the best, T2 = average, and T3 = the worst. The groups T1xT3 were compared regarding the performance of recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and for the intensities of 40%, 60%, 80%, and 100%. The association of independent variables over the performance of language was analyzed through logistic regression. The multivariate model was built from the results of the univariate analyses and has included the continuous variables by emotion and by intensity. Age and schooling associated to the performance of language in the univariate model were included in the multivariate model in order to adjust association analyses.

RESULTS

The sample was mainly female (84.7%), with an average age of 70.5 years old, and 3.5 schooling years. The variables associated to the best performance of language in comparative analysis of T1 and T3 were: surprise (OR = 1.485, IC 95% 1.194 - 1.846), and disgust (OR = 1.143, IC 95% 1.005 - 1.300).

CONCLUSION

The recognition of facial emotional expressions of surprise and disgust were shown as important factors associated to the good performance of language.

Validation of the Brazilian version of the Hinting Task and Facial Emotion Recognition Test (FERT-100) in patients with schizophrenia

Social cognition is an especially relevant domain in schizophrenia due to its association with functional impairment. However, we still do not have studies that have validated instruments with internationally established psychometric qualities for the Brazilian population.

Objectives

This study aimed to present psychometric qualities and contribute to the validation of the Brazilian version of the Hinting Task and Facial Emotion Recognition Test (FERT-100).

Methods

A total of 104 stabilized patients living in the community diagnosed with schizophrenia and 89 controls were evaluated. We assess the psychometric properties of Hinting Task and FERT-100 for discriminant construct validity, divergent construct validity, convergent construct validity, concurrent criterion validity, and reliability.

Results

There is a statistically significant difference between patients and controls regarding social cognition (Hinting Task: Z=6.85, p<0.001; FERT-100: t=4.88, p<0.001). The main predictors of variation in social cognition were the neurocognitive domains. The associations between social cognition tests and other studied variables are similar to what is found in the literature. Social cognition maintains correlation with functional capacity even when neurocognition is taken into account.

Conclusions

The validity of the Brazilian version of Hinting Task and FERT-100 can be determined, since the relationship of these tests with other clinical variables is similar to that observed in the literature.

Longitudinal Change in Neural Response to Vocal Emotion in Adolescence

Adolescence is associated with maturation of function within neural networks supporting the processing of social information. Previous longitudinal studies have established developmental influences on youth’s neural response to facial displays of emotion. Given the increasing recognition of the importance of non-facial cues to social communication, we build on existing work by examining longitudinal change in neural response to vocal expressions of emotion in 8- to 19-year-old youth. Participants completed a vocal emotion recognition task at two timepoints (1 year apart) while undergoing functional magnetic resonance imaging. The right inferior frontal gyrus, right dorsal striatum and right precentral gyrus showed decreases in activation to emotional voices across timepoints, which may reflect focalization of response in these areas. Activation in the dorsomedial prefrontal cortex was positively associated with age but was stable across timepoints. In addition, the slope of change across visits varied as a function of participants’ age in the right temporo-parietal junction (TPJ): this pattern of activation across timepoints and age may reflect ongoing specialization of function across childhood and adolescence. Decreased activation in the striatum and TPJ across timepoints was associated with better emotion recognition accuracy. Findings suggest that specialization of function in social cognitive networks may support the growth of vocal emotion recognition skills across adolescence.